Frozen Shoulder

Frozen shoulder or "adhesive capsulitis", is of unknown origin, mostly affecting 40-60 year olds. It causes severe pain and stiffness of the shoulder and is thought to be of autoimmune nature, triggered by factors such as illness, disease, inactivity, injury or trauma.

What is Frozen Shoulder?

Frozen shoulder or "adhesive capsulitis", is of unknown origin, mostly affecting 40-60 year olds. It causes severe pain and stiffness of the shoulder and is thought to be of autoimmune nature, triggered by factors such as illness, disease, inactivity, injury or trauma.

The shoulder capsule is a connective tissue structure surrounding or "encapsulating" the shoulder joint. Frozen shoulder causes swelling, thickening and tightening of the shoulder capsule with inflammation and scarring.

There are 3 stages of frozen shoulder;

  • The freezing (red) stage
  • The frozen (pink) stage
  • The thawing (white) stage

Each stage may be endured for 6 months or more before entering the next stage.
 

Serious Shoulder Pain? You need a shoulder expert!

If you have serious shoulder pain which won't go away, you need to see a shoulder expert.

Determining your condition is the first step in making a change to improve it. Dr Manish Gupta is an experienced shoulder specialist and will be able to determine your shoulder condition.

 

Symptoms

Frozen shoulder may exhibit the following symptoms;

  • Progressive loss of active and passive movement of the shoulder
  • Inflammation and swelling
  • Strong pain at rest and made worse by movement
  • Night pain and loss of sleep
  • Depression and helplessness

Causes

The cause of frozen shoulder is unclear. Frozen shoulder may arise soon after an obvious shoulder injury, but it may also arise spontaneously with no apparent reason or trigger factor as in the case of idiopathic frozen shoulder.

Major Shoulder Injury

Major shoulder injuries such as broken shoulder, dislocated shoulder and rotator cuff tears may cause onset of frozen shoulder as the body reacts to trauma.

Auto-Immune Trigger Factors

Frozen shoulder may be of autoimmune nature, which is thought to be brought about by trigger factors such as autoimmune disease, connective tissue disease, lung disease, heart disease, thyroid disease, diabetes, cervical cancer, shoulder injury, surgery, long periods of inactivitiy. Diabetic women aged 40-60 years old have the highest rate of frozen shoulder.

Diagnosis 

To diagnose frozen shoulder, the orthopaedic consultant will check the patient's;

  • Nature of the injury (sports, work, accident, overuse etc)
  • Cause of the injury (impact, collision, fall, repetitive/slow onset)
  • Context of the suffering (age, return to sport, work, impact on daily living)
  • Perform a physical examination to ascertain pain and range of movement
  • Perform specialised imaging like X-Ray, Ultra Sound and MRI to confirm diagnosis

Stage 1

  • Pain measure, how severe is your shoulder pain (scale of 1-10), and for how long have you suffered pain? Stage 1 lasts between 2-10 months and is the strongest pain stage of the condition.

Stage 2

  • In Stage 2 of the condition, pain begins to subside, but shoulder stiffness increases where neither you nor your doctor get much movement out of your shoulder. This stage may last between 4- 10 months.

Stage 3

  • In stage 3, both pain and stiffness begin to subside. This stage may last between 5-25 months.

Diagnosis and early treatment of frozen shoulder is extremely important to avoid chronic and long term issues associated with the condition. Book an appointment with Dr Gupta to get a thorough diagnosis of your shoulder condition.

Treatment

Frozen shoulder is an extremely painful condition. Dr Gupta is an experienced Orthopaedic specialist who has treated many sufferers of this debilitating condition.

Treatment begins with a thorough diagnosis to understand the severity of the condition in the context of your age, your sport, your work and your life to understand what is important to you about your recovery.

Non-Surgical

Depending on the stage of your frozen shoulder condition, there are a number of treatments which may help you. 

  • The freezing stage of frozen shoulder, the treatment goal is pain management. Your doctor can prescribe you appropriate medication which is safe and specific to your health and physiotherapy treatment can also help dissipate pain and maintain pain free movement.
  • The frozen stage of frozen shoulder, the treatment goal is pain management and gentle movement. Your doctor can monitor your pain medication and your physio can introduce gentle stretching of the shoulder joint.
  • The thawing stage of frozen shoulder, the treatment goal is regaining movement and return to living. Your doctor will monitor and start reducing your pain medication and your physio will introduce more agressive stretching and functional exercises of your shoudler. 

In most cases, frozen shoulder conditions will get better within 12-18 months.

Surgical

If non-surgical treatment fails, Dr Gupta may use the following surgical treatment of frozen shoulder;

MUH or Manipulation under Anaesthetic

A non-invasive procedure under anaesthetic help break down scar tissue without associated pain

Capsular release

A key hole surgical procedure releasing scar tissue and tight shoulder capsule

Post Op Rehab Protocol

Dr Gupta uses a clinically proven rehabilitation process for each of his operative procedures. Find out more about Capsular Release rehabilitation on our Post-Op Capsular Release Protocol Page.

If you're suffering ongoing shoulder pain and stiffness, you need an expert diagnosis right away.

Dr Gupta uses a systematic approach to diagnosis, treatment and return to sport or work advice is necessary to take back control of your condition and to prevent future complications.

Contact Dr Gupta on 02 9687 8344 or make an online booking here.